#1
|
||||
|
||||
ÈÌÕÎ - èíòåðåñíî: ìåäèöèíñêèå ññûëêè.
BMJ 2011; 342
Editorial Autoimmune encephalitis Treatable syndromes with characteristic clinical features It is essential not to miss potentially treatable causes of new onset confusion or amnesia. Once toxic and metabolic causes have been excluded, infectious encephalitis must be considered and treated. However, the results of a recent surveillance study in the United Kingdom found that only 42% of patients with encephalitis had an identifiable infectious cause. 1 Even just a decade ago, the cause of encephalitis in those without an identifiable infection may well have remained obscure. There is now unequivocal evidence that specific autoantibodies directed against neuronal proteins crucial to the control of neurotransmission are responsible for a proportion (~8% in one series 1) of such cases.2 Importantly, these autoimmune encephalitides may be treatable with immunotherapy.345678 Antibodies against two targets, the voltage gated potassium channel (VGKC) complex and the N-methyl-D-aspartic acid (NMDA) receptor, have emerged as important causes—more than 100 related or relevant articles have been published in the past two years alone. These autoimmune encephalitides have distinctive clinical features and can be diagnosed by simple serological tests. Despite almost certainly being underdiagnosed, about 400 patients with clinically relevant raised VGKC complex or NMDA antibody titres have been … [Full text of this article] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#2
|
||||
|
||||
Êñòàòè, ðàäèîëîãàì:
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#3
|
||||
|
||||
When LP Is Not Necessary to Detect Subarachnoid Bleed
CT performed within 6 hours of symptom onset in neurologically intact patients had 100% negative predictive value in this prospective multicenter study. Standard teaching is that lumbar puncture (LP) is essential in patients with suspected subarachnoid hemorrhage (SAH) despite normal head computed tomography (CT) scans. Researchers prospectively enrolled 3132 consecutive neurologically intact patients older than 15 who underwent head CT with third-generation multislice scanners to evaluate nontraumatic acute headache or headache with syncope at 11 tertiary emergency departments in Canada from 2000 to 2009. LP was performed at the discretion of the treating physician. Experienced radiologists who were blinded to the study interpreted all CT scans. SAH was defined by subarachnoid blood on CT, aneurysm on cerebral angiography, or xanthochromia in cerebrospinal fluid. Mean headache peak pain severity was 8.7 on a 0–10 scale. LP was performed in 49% of patients after negative CT scans. Overall, 240 patients (7.7%) were diagnosed with SAH. The sensitivity of head CT for SAH was 92.9%, and the negative predictive value (NPV) was 99.4%. Emergency physicians identified all but three cases of SAH; all three patients were scanned >6 hours after headache onset. Among 953 patients who were scanned within 6 hours of symptom onset, head CT had 100% sensitivity and 100% NPV. Follow-up at 1 and 6 months did not identify any cases of missed SAH. Comment: Because subarachnoid blood diffuses and hemolyzes within hours, CT might not be able to distinguish cerebrospinal fluid from blood as time passes. Patients with histories that raise concern for SAH should be prioritized to undergo CT within 6 hours of symptom onset. If CT is performed with a modern scanner and is interpreted as negative for SAH by an experienced radiologist, LP is unnecessary, unless it is being performed to detect other causes of headache. — Kristi L. Koenig, MD, FACEP Published in Journal Watch Emergency Medicine August 5, 2011 [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
__________________
Ñ óâàæåíèåì, Þñèô Àëõàçîâ. |
#6
|
||||
|
||||
Íåñêîëüêî ãàéäîâ îò American Academy of Neurology
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Îïóáëèêîâàíî â Neurology. 2012;78:139-145. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Îïóáëèêîâàíî â Neurology. 2011;77:2128-2134. |
#7
|
|||
|
|||
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
|
|
#8
|
||||
|
||||
Ïðîñòåéøèé îïðîñíèê äëÿ âûÿâëåíèÿ ïðèçíàêîâ êîãíèòèâíîé äèñôóíêöèè êàê ðàííåãî ôàêòîðà ðèñêà ðàçâèòèÿ áîëåçíè Àëüöãåéìåðà, ïðåäëàãàþò àìåðèêàíñêèå èññëåäîâàòåëè
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#10
|
||||
|
||||
Íîâûé ãàéäëàéí ÀÍÀ/ASA ïî âåäåíèþ íåòðàâìàòè÷åñêîãî ÑÀÊ
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Ïîëîæåíèÿ, äîáàâëåííûå è/èëè îáíîâëåííûå ïî ñðàâíåíèþ ñ ïðåäûäóùåé âåðñèåé Öèòàòà:
|
#11
|
|||
|
|||
Ñòàòüÿ èç CONTINUUMà ïî ýïèëåïòè÷åñêîìó ñòàòóñó :
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#12
|
|||
|
|||
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
Âîò îíî êàê, îêàçûâàåòñÿ. Áåäíûå ìû áåäíûå. Ó êîãî ÷òî áîëèò, òîò î òîì è ãîâîðèò? Öèòàòà:
|
#13
|
|||
|
|||
Acute and Preventive Treatment of Migraine îïÿòü èç CONTINUUMa
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#14
|
|||
|
|||
Óâàæàåìûå êîëëåãè, åñòü áåñïëàòíûé äîñòóï ê ñòàòüÿì æóðíàëà "Clinical Practice Neurology" îò AAN, êàê äîëãî îíè áóäóò áåñïëàòíî äîñòóïíû ìíå íåèçâåñòíî, èìååò ñìûñë ïîòîðîïèòüñÿ ñî ñêà÷èâàíèåì.
ññûëêè ïðèâîæó íèæå: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
__________________
Ñ óâàæåíèåì, Àíàñòàñèÿ Âàëåðüåâíà. Ìîé Instagram àêêàóíò @asarycheva |
#15
|
|||
|
|||
Recurrent Spontaneous Attacks of Dizziness: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
__________________
Ñ óâàæåíèåì, Àíàñòàñèÿ Âàëåðüåâíà. Ìîé Instagram àêêàóíò @asarycheva |